Candidate: Margaret Gourlay, MD, MPH is an assistant professor of Family Medicine at the University of North Carolina. Career Development Plan: the candidate will participate in coursework and mentored research to learn essential skills in osteoporosis study design and implementation and to develop academic leadership. Immediate Objective: to acquire expertise in epidemiologic and densitometric concepts in osteoporosis screening research. Long-term Objective: to decrease fracture-related morbidity and mortality in the elderly by advancing the development of an evidence-based osteoporosis screening protocol for postmenopausal women under age 65 in primary care practices. Specific Aims: 1) determine if two existing methods of fracture risk assessment are accurate in younger postmenopausal women, 2) determine if existing osteoporosis risk assessment tools are accurate in younger postmenopausal women, and 3) test the feasibility of a study of selective screening to identify osteoporosis in younger postmenopausal women. Research Methods: in aims 1 and 2, secondary analyses of data from the two largest US osteoporosis cohort studies (NORA, SOF) will compare the ability of a fracture index vs. peripheral bone density to predict fracture in postmenopausal women aged 50 to 64, and will compare the ability of osteoporosis risk tools to identify peripheral osteoporosis in younger vs. older postmenopausal women. In aim 3, a feasibility study that includes central and peripheral bone density measures will provide preliminary data for an R01 study of selective osteoporosis screening in younger postmenopausal women. Environment: patients will be recruited from 3 UNC primary care clinics and community family medicine clinics for the aim 3 feasibility study conducted in the NIH-funded General Clinical Research Center at UNC. Mentorship: mentorship will be provided by two highly successful NIA-funded researchers on aging (Drs. Sloane and Zimmerman), a national expert on screening methodology (Dr. Ransohoff), osteoporosis specialists (Drs. Rubin and Ontjes), and a biostatistical expert (Dr. Preisser). Investigators from NORA (Dr. Miller) and SOF (Dr. Ensrud) will supervise the analyses in aims 1 and 2. Relevance: osteoporosis is a common, preventable condition that leads to high fracture-related morbidity and mortality in postmenopausal women. This study will test osteoporosis screening strategies for postmenopausal women under 65 with the goal of preventing fracture.